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y. APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> % PROPOSEt7.PARCI=LS..... ..::....... <br /> Parcel Number Existing or Proposed Use of Parcel Square Footage <br /> or Acreage <br /> . ."' ::. SITE IMPRaYEMENT.�RND�SERVICES.... ; <br /> :...:: ...... . '.: ...:.... <br /> Public Water Service Provider Annex-Formation Distance to Public Water <br /> Existing❑ Required Feet <br /> Proposed❑ <br /> Private Water* Existing Well 0 New Well ❑ Well Replacement ❑ <br /> a <br /> S.ewaq <br /> d.D#s :isai <br /> Public Sewage Service Provider Annex-Formation Distance to Public Sewer <br /> Disposal <br /> Existing❑ Required Facility <br /> i Proposed❑ <br /> On-site Sewage Existing Septic System 0 New Septic System ❑ Other ❑ <br /> Dis sal <br /> Public Storm Service Provider, Annex-Formation Terminal Drainage Detention-Retention Ponds <br /> Drainage Required to: <br /> Existing❑ <br /> Proposed❑ <br /> Private Storm On-site Retention Pondisi ❑ Natural Drainage/No Change-0 Other ❑ If <br /> Drains a t# <br /> Electricit <br /> ;. Natural Gas .. .. <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> Tele hone Service <br /> Cable:Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> 94,C. C%L. F3�_= �.--c1 i 4 <br /> : . <br /> Schooi Service <br /> Fire Profection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> ' lLLittD6**�--PETEefUta►F►�D'_266o� t rJrnt. 2y�av C=�r�E- ,s�. M► <br /> :::Extstin (toads <br /> RoadlStreet Name R.O.W.Width Pavement Width 'Curb/Gutter Sidewalks <br /> Yes❑ No O Yes 0 No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> <:Pro sdd.Roads <br /> Road/Street Name R.O.W.Width Pavement Width CurbiGutter Sidewalks <br /> N <br /> Yes❑ No❑ Yes❑ No❑ , <br /> f <br /> Yes 0 No 0 Yes 0 No 13 <br />